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Mycobacterium avium Complex Pleuritis with Elevated Anti-glycopeptidolipid-core IgA Antibody Levels in Pleural
Koji Furuuchi1, Kozo Morimoto1,2, Keiji Fujiwara1
1Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Japan.
Abstract:
Pleuritis caused by nontuberculous mycobacteria is uncommon and difficult to diagnose. We herein report a case of Mycobacterium avium complex (MAC) pleuritis with elevated anti-glycopeptidolipid (GPL)-core IgA antibody levels in the pleural effusion. A 73-year-old woman with MAC pulmonary disease presented with massive left pleural effusion. A pleural biopsy by video-assisted thoracoscopic surgery was performed, revealing many noncaseating epithelioid cell granulomas. MAC was not identified by culture of the pleural effusion or specimens, but the anti-GPL-core IgA antibody level was markedly elevated in the pleural effusion. Measurement of anti-GPL-core IgA levels in the pleural fluid may be useful for diagnosing MAC pleuritis.
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